dont waste your money,...
thats placebo effect at best.
if you want to relax, learn the basics and develope a routine, same things each day. you CAn teach yourself to sleep unless pain keeps you awake.
get a sleep pattern.
no smoking 2hrs before bed.
no alcohol 4 hrs before bed. (rebound effect keeps you awake)
foods, learn which help you relax, like Turkey.
some meditation or mild yoga
breathing, and learn bio feedback.

go get some meletonin at the pharmacy. less than 3mg.

if you do half these things,you will get to sleep. even if its 5 hrs steady sleep, that is the beginning and you will learn to sleep as long as you need. if 5 is not enough, after that and working or being active all day you will slowly gain more REM sleep time. having 4 hrs of REM sleep is as good or better than 8 of in/out sleep.
also, check to see if there are Apnea issues. that will prevent ANY REM sleep and that will make you extremely tired, exhausted even. I ended up having to use a cpap machine because i was not breathing enough to live, sleep and wake up. look into the apnea. even if its not dangerous, it will leave you totally exhaUsted. and then theres too much adrenelin and stress to get to sleep the next nite. not sleeping becomes a pattern just as good sleep is supposed to be a pattern.

Ambien/Zolpidem is highly addictive and might be one of the most abused prescription drugs that exist. Nephro please enlighten this person about it's potential for abuse and the dangers of withdrawal.

Playing with fire.

Bags,

i have no issues with it, are YOU unable to manage YOUR meds properly??

i can and do well. after several years of ambien, i am fine.
maybe its YOU with the problem with the meds. most use these for sleep, what were you using it for??

why ask nephro to "enlighten" me? are you only allowed one post per day or something?
i have no problems with ambien, then again, i do not abuse it. perhaps your result was because of your use of it and HOW you used it.

asking someone to enlighten me....jeeeeeeze

I have had heard of people getting addicted to ambien. A few online friends.

Personally, I alternate between halcion, ativan, sonata, and melatonin and unisom (not the one with diphenhydramine (sp??)

I did have Ambien CR to add to that mix, but dropped it. I never take any of them at the same time except with maybe a melatonin. The halcion doesn't knock me out like they say it will and I don't have the sleep memory problems. Otherwise, I'd dump it too.

Sweetz,
i just do not understand what an ambien addiction is...

what does that mean?
cravings? the need to take one at anytime? the lack of being able to sleep? that is called rebound effect and that happens with any drug. addiction is something completely different.

so if you dont mind, would you explain the symptoms of Ambien addiction?

because if used as directed, it is NOT addictive. i have been using ambien about 300 days out of the year since it came out and have no issues. if i run out i use some OTC drug or nothing at all and i suffer no symptoms of withdrawel of any kind.

so, please tell me what it is? i am curious as to how proper use causes addiction to this drug?

oh yeah, watch the melotonin, that if taken too often will cause some very vivid dreams that can turn into nightmares. I have experienced that before and believe me, they are VERY real feeling and the dreams are very detailed and vivid.

I have (unmedicated) ADHD and have a difficult time winding down at night. I have used Valerian Root Extract 1000 mg and Melatonin 3mg for about 15 years. Valerian is a very smelly but effective herb. It is the answer for me anyway. You can buy it at Walgreens, CVS and most drug stores. I buy mine from Puritans Pride online. I have the bottle here with me. Their phone number is: 1-800-645-1030 The item # is #1328 for 90 (smell proof)softgels at 1000 mg each. I just called and bought a few 2 days ago. They are having a buy 1 get one free sale or buy 2 get 3 free. They run about 7 or 8 dollars a bottle. You will rest deeply without a hangover. Sometimes I will take a couple more during especially restless nights. I have worked myself up to 4 softgels a night. One or two should do it for anyone not used to Valerian root. This is truly a wonderful way to sleep deeply. I dream the most wondeful dreams. Try it and you will see for yourself! Most people have never tried it.

I usually take a melatonin with my gels. My husband loves them too! He refers to the melatonin as a sleep train that comes through initially. You must be ready to sleep when that train comes through otherwise it passes on by without you! Once the melatonin helps you to FALL asleep the valerian helps you to STAY asleep.

Also, Sam's sells Tylenol PM without the Tylenol (Members Mark Sleep Aid gels) reasonably. This works well when I sometimes want to alternate meds.

Oreos and milk help my husband. I have read that DAIRY products help us to rest. It sure helps him.

Vitamin World is the same company as Puritans.

I know how hard it is to work the next day when you did not rest well. I hope that this may help someone out there. I cannot begin to tell you how much help that I have been given as a result of your posts over the years. All of you guys are the greatest!

Hello,
Tell me again what the same of the tylenol PM without tylenol is that is sold at Sam's???
Thanks in advance!

Diphenhydramine aka Benadryl

I think you have to look at the source of the problem that keeps you awake... and work on that...
Find out what is keeping you from sleeping and try to solve that...

You just can not go on trying med after med to see if it puts you to sleep...

I cannot get my doctor to prescribe anything for sleep but Ambian. He has been writing the scripts for about two years. I took it as scripted for the first couple of months, then realized the extent of the memory lapses. I asked another doctor if I could switch and he said no, stick with what the first was giving me. I get them refilled about once every three or four months, and I only take 1/2 a couple of days a week. The other days I take different herbal and OTC meds to try to sleep. None of them ever work 2 days in a row.

I am with eluded on this one. I know several people who take it off and on, just like I do, and a couple that take it every day. There are no reputable sources online that say it is addictive, just anecdotal accounts. If people abused it would they not just be asleep all the time? The literature that comes with my script from the FDA says it is not addictive.

The people who abuse it apparently don't sleep; they deliberately stay awake, and in some cases, take it during the day:



http://jop.sagepub.com/cgi/content/abstract/17/1/131



http://www.ncbi.nlm.nih.gov/pubmed/10627964

(article in German, unfortunately!)

It would seem that a lot of cases of dependence occur when the dose has escalated; it is not clear how the dose escalated in the first place, however. If it was deliberate abuse, then zolpidem may be relatively safe when taken as prescribed. If tolerance was the cause of increasing doses, then that's a little more worrying.

Sure thing.....I have the Sam's bottle in front of me. Okay....It is sold as a pair (purchased 3 days ago)of bottles and reads : Members Mark Sleep Aid....Diphenhydramine HCI 50 mg each softgel...Maximum strength. Each bottle contains 96 gels. I sometimes take 3 or 4 when not taking other stuff. They knock you out without more Tylenol. I have been on Hydro 10/325 so long that I do not want to take any extra Aspirin or Tylenol. My friend really swears by the poppy pod tea(not seed tea) to prevent wd's from any opiates as well as a deep rest when out of meds. For me I keep several things on hand. You have to switch up sometimes. The UPC on the Sam's bottle is :6 05388 19982 9

The pair of bottles is about 9 or 10 dollars. I hope that this helps you.

Have a nice night and thank you for inquiring.

Diphenhydramine is a 'Red Card' item in UK pharmacies, which means pharmacists must have OTC sales brought to their attention, and there are misuse/dependence issues.

I can't imagine any hypnotic not carrying at least a slight risk of dependence, since with constant use, the body is being adjusted to sleep by the medicine, and will not want to when the medicine is abruptly discontinued.

When a new drug, or group of drugs, is introduced with claims that they are superior to their predecessors, my first though is not to believe them. Rather cynical, but benzodiazepines are about as addictive as barbiturates; OxyContin at least as addictive as morphine. In both cases, claims were made that they had less risk of dependence than what went before them.

Tramadol is another example of not being quite the risk-free drug that was hoped.

That is so true of many new drugs touted as being safer and more effective than older ones. I remember going into a pharmacy back in the 90s, when all kinds of stuff was available over-the-counter - benzos, Ritalin, codeine, Luminal, and much else besides - and asking for a strip of ten 5mg Valiums for my back pain. The guy pulled out a box of 100 Dormicum 15mg tablets (midazolam) and told me that they were a 'new and improved' version of Valium, and said I could take as many as I wanted, that they were completely safe. He was really doing his best to sell them to me.

Another shop had bottles of Rohypnol behind the counter. And fifteen years before that, I remember seeing Doriden and Quaalude for sale, wholes bottles of them (they were taken off the shelves after increasing numbers of suicides).

The rehabilitation centre I went to when I first injured myself was in the basement of the main hospital here (at the time), and in the afternoons people would set up stalls in the corridors, selling everything from cheap clothes to pirated Rolexes to prescription medicines. I recall seeing boxes of Apisate (diet pills) and Equagesic (muscle relaxants/analgesic) there - actually being offered for sale right inside the hospital! Insanity.

Thanks for the quick reply, pained!

Probably almost anything can result in some type of dependence if used regularly. That doesn't mean everything will cause problems with daily living or unmanageable problems when discontinued. Actually, I've had Asian friends tell me they don't feel right if they don't eat rice every day. Dependendence? I think probably so to some extent. We get used to certain things, even diets, and then it can be hard to change.

The incidence of ambien abuse is an epidemic in this country. This a very addictive drug. Doctor's give it away like candy and the amount of stories of sleep driving, sleep eating, hallucinating and doing other strange things under the influence of the drug are flabbergasting.

If you're so in control of the drug stop using it completely...... You still there. Go 45 days without ambien and tell me how you feel in day six after using all these years of using. You're addicted to it but don't even know it my friend.

Nephro,

Regular ambien is recommended for use for just 7-10 days in the US. For some reason they say ambien CR can be taken for long periods of time under a doctor's care. Alot of rehab clinics have popped up in the last 18-24 months here in the US that simply treat ambien addiction. Even at a regular 10mg dose there have been stories about people having the same problems and awful side effects than those who take more than the recommended dosage. All I am saying is that it is physically and psychologically addictive and was never meant for long term usage. I just want people to be aware of its dangers. Withdrawal of ambien is also very dangerous and can lead to seizures and death.

Indeed, acute poisoning has been successfully treated with flumazenil, and as one of the sources posted, zolpidem loses its selectivity as the dose increases and acts more like a traditional benzodiazepine.

Both those situations would point towards it being dangerous to suddenly cease after prolonged use at high doses at least.

The reason Ambien is only "indicated" for 7-10 days is because that's how it was originally approved by the FDA. At that time there was no experience or studies involving long term use. When the patent for Ambien expired, the company needed a new patentable product to replace it. Hence, Ambien CR. By that time there was enough information on long term Ambien use to remove the 7-10 day limit for the FDA approved "indications". They could go back and change the official indications for Ambien to remove the time limit, but to do so would require new studies and would be very expensive. That expense can't be justifed for a medication that is no longer under patent protection. Besides there is no need, since doctors are free to prescribe medications "off label" anyway, meaning that they are not required to follow the FDA indications if they don't want to. The legal effect of the old Ambien labeling is simply that it cannot be advertised or otherwise promoted for off label use.

Riverboat -

You are very welcome!

The real help for me comes from the Valerian Root Extract capsules (mentioned in previos post). I prefer herbal over the counter assistance over prescriptions to sleep. The valerian root 1000 mg capsule is just the most amazing sleep enhancer around.

Riverboat... I would love for you to try it, if you have not already.

Have a nice evening!

As I said I was really puzzled by some of these statements,so started doing research. I have never experienced any withdrawal symptoms when I would stop taking it, whether it had been 3 months or 3 days.

Ambien information from the FDA site:

Abuse and dependence
Studies of abuse potential in former drug abusers found that the effects of single doses of Ambien (zolpidem tartrate) 40 mg were similar, but not identical, to diazepam 20 mg, while zolpidem tartrate 10 mg was difficult to distinguish from placebo.
Sedative/hypnotics have produced withdrawal signs and symptoms following abrupt discontinuation. These reported symptoms range from mild dysphoria and insomnia to a withdrawal syndrome that may include abdominal and muscle cramps, vomiting, sweating, tremors, and convulsions. The U.S. clinical trial experience from zolpidem does not reveal any clear evidence for withdrawal syndrome. Nevertheless, the following adverse events included in DSM-III-R criteria for uncomplicated sedative/hypnotic withdrawal were reported during U.S. clinical trials following placebo substitution occurring within 48 hours following last zolpidem treatment: fatigue, nausea, flushing, lightheadedness, uncontrolled crying, emesis, stomach cramps, panic attack, nervousness, and abdominal discomfort. These reported adverse events occurred at an incidence of 1% or less. However, available data cannot provide a reliable estimate of the incidence, if any, of dependence during treatment at recommended doses.

So basically the FDA says that the abuse potential of 10 mg was difficult to distinguish from those abusing placebos that they thought was a drug. When they studied withdrawal effects by placebo substitution it occurred at 1% or less. There is no reliable evidence of dependence at recommended doses.


So I did a comprehensive search on "Ambien Addiction" I found a ton of clinics and treatments centers that maintained it was a massive problem and that they treated it. The problem I saw right away was the fact that the "symptoms of addiction" that they listed were actually side effects. The other thing frequently listed was a problem getting to sleep without it, and rebound insomnia. Rebound insomnia is a normal side effect, and insomnia is why you are taking it in the first place, right? That is like saying that Type 2 Diabetics are addicted to insulin.

Many of the more reputable clinics noted on their website that Ambien when taken as prescribed was not a risk for addiction or abuse. They went on to state that When abused, Ambien tablets are taken orally, crushed and then snorted, or dissolved in water and "cooked" for intravenous injection, NOT taken as prescribed.

I could not find anything in a Google search to substantiate Ambien addiction, the only things found were forums were people claimed they or a relative were addicted, or clinics wanting your money to cure you of it. Nothing by doctors, medical studies, that type of thing. They may exist, but I could not find them.

Since I have access to online medical journals I started searching there. I found one study that found 2 cases of actual dependance. I found several articles discussing how Ambien's undesirable side effects were much more extensive than originally thought, and how many clinics were taking advantage of that fact to treat people who take it. No studies that I could find have given any credence to actual addiction to Ambien taking place.


Do not take this to mean that I think this drug is ideal, nor that I think it's side effects can not be extremely dangerous. I never take it unless someone else is home, and I turn over the bottle and my car keys on those nights. I have never left the house, but apparently I do have fascinating conversations with people. When my sister and I are at our university apartment when take turns, never do we both take it the same night.

The problem with searching for "Ambien addiction" is that it excludes most of the world. Apart from the USA and Hungary, the brand name is different - usually Stilnox, Stilnoct or similar. Ludes_Vet will know more than I do on this. This is the main reason medical journals do not refer to brand names.

Some examples are:

"A Case of Zolpidem Dependence Successfully Detoxified with Clonazepam", American Journal on Addictions, Volume 17, Issue 4 July 2008 , pages 343 - 344.

"A warning regarding the potential of zolpidem dependence", Reactions, Volume 1, Number 746, 1999 , pp. 2-2(1)

"Zolpidem dependence case series: possible neurobiological mechanisms and clinical management", JOURNAL OF PSYCHOPHARMACOLOGY 2003, VOL 17; PART 1, pages 131-135

"Zolpidem withdrawal: CNS disorders and facial flushing in an elderly patient: case report", Reactions, Volume 1, Number 874, 2001 , pp. 12-12(1)

It appears that evidence of dependence and withdrawal is lacking at recommended doses, but much more prominent at supratherapeutic doses. The question is, why are some patients taking such high doses? If they set out to deliberately abuse the drug from day 1, then regular users are pretty safe. If they had to escalate the dose due to tolerance and resultant insomnia, then that is more worrying.

The manufacturer instructs that the drug is not taken for longer than 4 weeks in Australia; they also say that patients in trials have not experienced any problems upon discontinuation within this period:

http://www.sanofi-aventis.com.au/products/aus_cmi_stilnox.pdf

The drug is also relatively new compared to the benzodiazepines, barbiturates and ethanol, so the full story may not emerge for years to come.

I used to be prescribed Rohypnol for my insomnia, and it worked quite well, although it does leave you feeling a little groggy the next morning sometimes (more so than Halcion or Dormicum). They changed the colour from white to green after all the cases of 'date-rape' started to emerge.

Flunitrazepam is effective for what it was designed for - it's only people abusing it that have given it a bad name in people's minds. I don't think its effects are much different from those of temazepam, really.

Has anyone had any luck with zaleplon? I was in a pharmacy yesterday, picking up a prescription for my mother, and I noticed a box of it on the counter. I asked the pharmacist and he said it's an over-the-counter hypnotic, but I could swear it was prescription only. It's not OTT in the UK or US, is it?

I looked it up under the other names Nephro, I just used Ambien in my post because that was the name we were discussing it here. I also mentioned in my post that it was in regards to regular usage as prescribed.

Why people are using really high dosages is a good question.

A big problem that is arising in the US is the term "Ambien Addiction" when discussing the regular use at recommended doses. What is being discussed when this is mentioned is not "addiction" per se, and has become big business for "for profit" clinics and treatment centers. People who take it as prescribed by their doctors are then being recommended for treatment for addiction by their families. They are taking for insomnia in the first place, when they stop taking it, they go back to not being able to sleep, and this is being used in the criteria for determining that they are addicted, along with the normal side effects occurring while taking it.

So basically anyone who takes it as recommended, stops taking, and still has trouble sleeping meets these businesses descriptions of "Ambien Addiction".

If you have chronic pain and quit taking pain medications and still have pain, does that make you an addict? If you take birth control pills for medical reasons (as opposed to birth control) and have the normal side effects, quit taking them and and the symptoms return, we do not consider you addicted to birth control pills.

That is exactly what doctors in these journals say is happening with Ambien. Taking 40 mg twice a day is a whole other story. Regardless of what those people are doing, it is unethical for these clinics and centers to list the normal side effects of a medication and tell people that makes them addicted so they will enter treatment and get charged a ton of money.


It is similar to another widely misrepresented situation. The multitude of people who think they are allergic to Imitrex because their blood pressure spiked really high, their throat felt like it was tightening for a few minutes, the pain increased substantially for a few minutes, etc. Doctors who did not read the literature told people they were allergic. This was actually the normal reaction that eventually stopped happening, and is not as noticeable with the newer drugs in that class.

Like I said , I am not a big fan of Ambien, but cannot get anything else prescribed to me for sleep because it is listed as non-addictive by the FDA.
At anything more than 5 mg I have memory lapses, and that is half the dose I am prescribed.

Bluefairy, I agree with you.

I took Ambien every night for around 5 years. Started taking it about the time it hit the shelves. When it went generic, my doctor prescribed Ambien CR instead.

I never took it except one pill at night before bed. If I ran out, I used Doan's PM to help me sleep. The whole point of me using it was that I couldn't sleep because of the pain. I was never addicted, never had any problems stopping the useage of it, and there were times when I had plenty of Ambien CR, and chose to use Doan's PM that night because it worked better.

If someone is taking 40 mgs of it twice a day, that's abuse of the medicine. If someone is taking 1 pill a night to get to sleep, then you'll using it as you are supposed to. And yes, I was told by my doctor that if I stopped using it I could expect to have some sleepless nights, but then everynight was a sleepless night without something to help me.

I stopped taking Ambien a couple of months ago and saw no difference in my body or how I reacted. I use either Doan's PM or Valerian Root Extract to help me sleep (I need some capsules because I have the powder form of Valerian Root and it's nasty tasting!).

Anything can be abused if you want to. I would think that taking 80 mgs of Ambien a day would mean either someone was sleeping all day or was abusing it in some other way to get some type of high. The only thing it did for me was to relax my body initially and then about 30 minutes later I'd fall asleep.

I always had some type of memory loss if someone woke me up to tell me something. But that's a side effect of the medicine and not an addiction problem. I had conversations with my kids that I didn't remember until they reminded me of them the next day. No big deal. Never tried to drive, never really did anything stupid; I simply didn't remember any conversation someone tried to have with me after I took it. I think my kids took advantage of the fact that I didn't remember conversations because they would wait until I fell asleep and then wake me up and ask if they could spend the night with a friend and I said yes and went back to sleep. Of course, the next morning I'm going "Where is my kid?" and one of the other kids would say, "Don't you remember? you told her she could spend the night out". LOL- kids aren't stupid nowadays!

I'll be going to my family doctor pretty soon and will probably go back on Ambien CR now that I've been off of it since November. The Doan's doesn't work as well as it used to, and I can't seem to take enough of the Valerian Root to really get a great night's sleep. I guess I could uncap some of my vitamins and put the Valerian root in there. In fact, I might do that today!

Off topic I admit - but I just wanted to let Bluefairy know that I was also a long time user who felt absolutely no withdrawal from quitting Ambien. But then, I don't have any problems stopping Soma either, whereas others seem to have a problem. I can also take Valium for a month and then quit without a problem. My doctor used to prescribe Valium for me quite a bit and I never gave it much thought when I ran out as I only used it as a sleep aid.

It's not OTC in the UK or US. I have used it with success, when I find I can't sleep, it's 4am and I need to get up for work at 7.30. It can give you a short sleep that makes a difference the next day. I would, however, set a loud alarm if used in this way.

It is indicated mostly for those who have difficulty in falling asleep, but can maintain sleep without much problem, because it has an incredible short duration of action. Patients are encouraged not to take a second dose if they awaken early, and should probably be transferred to a longer acting sleep aid.

There are always going to be the occasional patients who can quit drugs suddenly with no withdrawal symptoms that other patients generally can't.

Whether addiction can occur depends on whether the drug has any reinforcing properties. I don't know personally, but it certainly has when taken in supratherapeutic doses. This is where the analogy between reinforcing drugs and, say, insulin breaks down: if a diabetic's body miraculously healed such that he didn't need insulin any more, he could stop it with no issues. Benzodiazepines, on the other hand, are likely to produce withdrawal effects after prolonged use, regardless of whether the source of the anxiety or insomnia has disappeared or not. This is due to changes in receptor activity and homoeostasis.

Similarly, taking opioids for a long period for chronic pain will produce a withdrawal syndrome when stopped, even if the pain is no longer there, because of the reinforcing properties of opioids. It's back to the old 'dependence/addiction' issue again.

There is a theory that very short-acting hypnotics such as zolpidem and zaleplon, and the traditional benzo triazolam, 'withdraw themselves' each day due to the time the drug takes to wear off. Maybe this is behind the apparent safety of zolpidem used once every 24 hours?

I can't imageine me getting 3 hours of sleep, getting up for work and actually finding my keys using this stuff. Just my 2 cents.